Problems of Protection
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| Skin, hair, and nails | Integumentary system
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| Skin protects against foreign invasion by providing a first, second, and third lines of defense known as: | The moat, the castle wall, and the knights and soldiers
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| Specialized cells present in the skin that engulf any foreign substances (antigens) that invade the body when the skin is injured and then alert the immune system. | Langerhans' cells
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| The largest organ of the body that plays a major role in homeostasis. | Skin
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| What is the role of skin in homeostasis? | Helps regulate body temperature and maintains fluid and electrolyte balance
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| The 3 layers of the skin | Subcutaneous fat (adipose tissue), dermis (corium), and epidermis
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| The innermost layer of the skin, lying over muscle and bone | Adipose tissue
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| What is the function of fat cells in skin? | energy reserve in event extra calories are needed to power the body; heat insulators; absorb shock; and protect against injury by padding internal structures
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| The layer above the fat layer | Dermis or corium
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| What is the composition of the dermis? | connective tissue that contains no cells; collagen; and elastic fibers that are interwoven to give skin both flexibility and strength
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| Protein formed by dermal cells; the main component of dermal tissue; increases in injured areas and helps form scar tissue | Collagen
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| Dermal cells | fibroblasts
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| A protein lubricant produced by fibroblasts that contributes to the skin's normal suppleness and turgor | Ground Substance
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| The major component of elastic fiber | Elastin
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| Rich in sensory nerves that transmit sensatons of touch, pressure, temp, pain, and itch | Dermis
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| The dermis has capillaries and lymph vessels for the exchange of what two components? | oxygen and heat
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| The outer layer of skin | Epidurmis
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| Finger-like projections that anchor epidermis to dermis tissue | Dermal papillae
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| The fingers of epidermal tissue that project into the dermis | Rete pegs
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| Protective barrier between the body and the environment that is less than 1mm thick | Epidermis
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| How does the epidermis recieve its nutrients? | By diffusion from the blood vessels in the dermal layer through the basement membrane
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| Basal cells attaached to the basement membrane that continuously divide to form new cells | Keratinocytes
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| Older keratinocytes that are pushed upward and flattened to form the stratified layers of the epithelium | Malpighian layers
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| The outermost skin layer; dead cells that are shed from the skin | Stratum corneum or horny layer
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| The protein that makes the horny layer waterproof | Keratin
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| How long does a keratinocyte take to move from the basement membrane to the skin surface | 28 to 45 days
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| Activated in epidermis by UV light | Vitamin D
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| Where does vit D promote uptake of dietary calcium? | Intestinal tract (distributed by blood)
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| Pigment-producing cells found at basement membrane that give color to skin and account for racial differences in skin tone | Melanocytes
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| What causes darker skin tones? | The size of the pigment granules contained in each cell
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| Pigment granules | melanin
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| What is the role of melanin | To protect the skin from damage by UV light
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| Melanin production increases in areas that have what characteristics? | Endocrine changes or inflammation
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| A thick protective pelt worn by most mammals | Hair
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| Located in dermal layer of skin, but are actually extensions of the epidermal layer | Hair Follicles
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| Formed by a round column of keratin within each hair follicle | Hair shaft
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| Tougher than skin keratin | Hair keratin
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| What determines a person's hair color? | genetical determined by rate of melanin production
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| hair growth occurs in _______ | cycles; growth phase followed by resting phase
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| Extensions of keratin-producing epidermal layers of the skin | nails
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| Nails serve as useful tools for ____ and _____ | grasping and scraping
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| The white, cresent-shaped portion of the nail at the lower end of the nail plate | lunula
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| Nail keratin is formed and nail growth begins here | Nail matrix (Lunula)
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| A continuous but slow process | nail growth
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| How long does fingernail replacement take? | 3-4 months
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| How long does toenail replacement take? | up to 12 months
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| A layer of keratin at the nail fold that attaches the nail plate to the soft tissue of the nail fold | Cuticle
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| Distributed over entire skin surface except for the palms and hands of soles of feet | Sebaceous glands
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| A mildly bacteriostatic fat-containing substance that lubricates the skin and reduces water loss from the skin surface; Produced by sebaceous glands | Sebum
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| Eccrine and apocrine glands | Sweat glands
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| Arise from epithelial cells; found over entire skin surface and are not associated with the hair follicle; odorless, colorless, isotonic secretions | Eccrine sweat glands
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| Role of Eccrine glands | Regulation of temperature
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| stimulation of sweat form eccrine glands & resultant water evaporation can cause the body to lose as much as ____ of fluid in a single day | 10-12 Liters /day
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| In direct contact with the hair follicle; interactions with skin bacteria with secretions causes distinctive body odor | Apocrine Sweat glands
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| The single most important factor leading to degeneration of th skin components | chronic sun exposure
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| Can increase risk for skin lesions and delay wound healing | Protein deficiencies, vitamin deficiencies, and obesity
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| Can lead to vitamin deficiencies and related skin changes | fat-free diets and chronic alcoholism
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| Initial reaction to a problem that alters one of the structural components of the skin | Primary lesion
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| Changes in appearance that occur with progression of an underlying disease or in response to a topical or systemic therapeutic intervention | Secondary lesion
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| thickend skin | lichenified
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| ABCD (Skin cancer) | Asymmetry: of shape Border: irregularity Color: variation within one lesion Diameter: greater than 6 mm
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| TSSE | Total skin self-examininatoin (monthly)
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| May reflect problems of excessive moisture | Rashes
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| Freckles, flat moles, rubella; flat lesions of less than 1 cm in diameter; white, red, or brown | Macules
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| Lipomas; elevated marble-like lesions more than 1 cm wide and deep | Nodules
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| vitiligo, cafe au lait spots; macules that are larger than 1 cm in diameter; slight scale or fine wrinkles | Patches
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| sebaceous cysts; nodules filled with either liquid or semisolid material that can be expressed | Cysts
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| Warts or elevated moles; small, firm, elevated lesions less than 1 cm in diameter | Papules
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| acute dermitities; blisters filled with clear fluid; less than 1 cm in diameter | Vesicles
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| second-degree burns; blisters filled with clear fluid; greater than 1 cm in diameter | Bullae
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| psoriasis or seborrheic keratosis; elevated, plateau-like patches more than 1 cm in diameter that do not extend intot eh lower skin layers | Plaques
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| acne, acute impetigo; vesicles filled with cloudy or purulent fluid | Pustules
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| urticaria, insect bites; elevated irregularly shaped, transient areas of dermal edem | Wheals
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| varicella; wider than fissues but involve on the epidermis; often associated with vesicles, bullae, or pustules | Erosions
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| exfoliative dermatitis and psoriasis; visibly thickened stratum corneum; appear dry and usually whitish; seen most often with papules and plaques | Scales
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| stage 3 pressure sores; deep erosions that extend beneath the epidermis and involve the dermis and sometimes the subcutaneous fat | Ulcers
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| eczema, late-stage impetigo; composed of dried serum or pus on surface of skin, beneath which liquid debris may accumulate; frequently result from broken vesicles, bullae, or pustules | crusts and oozing
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| chronic dermatitis; palpably thickened areas of epidermis with accentuated skin markings; caused by chronic rubbing and scratching | Lichenifications
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| athlete's foot; linear cracks in the epidermis, which often extend into the dermis | Fissures
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| Striae, aged skin; characterized by thinning of the skin surface with loss of skin markings; skin is translucent and paper-like; skin depression occurs when dermal layer is involved | Atrophy
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| Ringlike with raised borders around flat, clear centers of normal skin | annular
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| circular | circinate
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| well-defined with sharp borders | circumscribed
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| several lesions grouped together | clustered
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| lesions that merge with one another and appear confluent | coalesced
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| widespread, involving most of th body with intervening areas of normal skin; generalized | diffuse
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| occurring in a straight line | linear
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| with wavy borders, resembling a snake | serpiginous
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| all areas of the body involved, with no areas of normal-appearing skin | universal
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| classified as normal or abnormal, depending on the cause | vascular changes or markings
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| birthmarks, cherry angiomas, spider angiomas, venous stars | normal vascular changes
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| bleeding under the skin that may progress from red to purple to brownish yellew, petechiae, and ecchymoses; abnormal | purpuric lesions
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| small, reddish purple lesions less than 0.5mm in diameter that do not fade or blanch when pressure is applied; indicate increased capillary fragility | petechiae
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| a condition frequently seen in patients who have chronic venous insufficiency | Stasis dermatitis
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| larger areas of hemorrhage that range in size from several millimeters to many centimeters | ecchymoses
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| lice eggs | nits
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| A collecton of patchy or diffuse white or gray scales on the surface of the scalp | Dandruff
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| Excessive growth of body hair or hair growth in abnormal body areas | Hirsutism
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| May occur as a result of circulatory problems and decreased blood flow to extremities | body hair loss, especially on feet or lower legs
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| Abnormal nails | Dystrophic
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| Fungal infection that may cause a "heaped-up" appearance of the toenails | Onychomycosis
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| Required to soften the nail plates before they can be trimmed | warm-water soak or lubrication with petroleum jelly
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| Thin and bend easily with pressure; associated with malnutrition, chronic arthritis, myxedema, and peripheral neuritis | soft nail plates
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| can split; may be caused by repeated exposure to water and detergents, whcih damage the plate over time | brittle nails
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| Separation of the nail plate form the nail bed | Onycholysis
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| Inflammation of skin around the nail that often occurs with a torn cuticle or ingrown toenail | paronychia
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| Lifting or puncturing of the outer surface of a lesion | unroofing
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| A small, circular, cutting instrument ranging in diameter from 2-6 mm; small plug of tissue is cut and removed ; closed with 1-2 sutures or no sutures necessary | Punch Biopsy
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| Remove only the portion of skin elevated above surrounding tissue when injected with loal anesthtic; indicated for superficial or raised lesions; use of scalpel or razor blade | Shave Biopsy
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| Larger or deeper specimens obtained by excision with scapel; sutured | Excisional Biopsy
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| May control bleeding of biopsy site | Topical hemostatic agent
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| A handheld, long-wavelength ultraviolet (black) light | Wood's light
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| A noninvasice and painless techinque that eliminates erythema cause by increased blood flow to the skin | Diascopy
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